Activity Restriction Research Articles

Analysis of the Impact of Yogyakarta International Airport (YIA) on the Financial Independence of Kulon Progo Regency

This research aims to analyze the impact of YIA's existence on the financial independence of Kulon Progo Regency during three different time periods, namely the pre-COVID period (2018-2019), the Community Activity Restrictions (PPKM) period (2020), and the period entering the new normal era (2020). 2021-2022). The approach used in this research is through regional financial ratio analysis with a focus on taxes and levies. The research results show that the existence of YIA has a significant impact on tax and retribution revenues in Kulon Progo Regency. The results of this research provide a better understanding of the impact of YIA's existence on regional finances and can be used as a basis for making better policy decisions in the future

Antipsychotic Prescribing and Falls Risk in Nursing Home Residents with Dementia

Abstract Background Falls are a common syndrome in older adults leading to adverse outcomes including functional decline, activity restriction, injury and death. They can still occur in residential care. We examined prescribing of medications included in STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk) (1) in nursing home residents with dementia. Methods A point prevalence audit was conducted in a dementia-specific nursing home. Data were collected from the electronic healthcare record on demographics, dementia severity, and number of falls in the preceding 12 months. The number and class of regular medications were recorded. Non-cognitive symptoms of dementia were quantified using the Cohen Mansfield Agitation Inventory (CMAI). Results Seventy-four residents were included with mean age 82 years, 59(70%) female. The average Mini Mental State Examination (MMSE) was 5/30 and 80% had severe dementia. The average CMAI score was 50. The mean number of falls was 3 (range 0-14). Regular prescribing of specific STOPPFall medications was as follows: antipsychotics 42/74 (57%), benzodiazepines 8/74 (11%), opioids 13/74 (18%), antidepressants 44/74 (59%), antiepileptics 11.74 (15%), diuretics 12/74 (16%). Prescription of a regular antipsychotic was associated with one or more falls (OR 3.19, p = 0.029). There was no significant difference in falls with the other medications studied. The number of falls increased with higher agitation scores. Conclusion Antipsychotics increased the risk of falls in a nursing home setting. Fallers had higher rates of agitation, perhaps explaining the increased usage of antipsychotics. Medications should be reviewed on a regular basis and deprescribing considered where appropriate. Reference 1. Seppala LJ, Petrovic M, Ryg J, Bahat G, Topinkova E, Szczerbińska K, et al. STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk): a Delphi study by the EuGMS Task and Finish Group on Fall-Risk-Increasing Drgs. Age and Ageing. 2020;50(4):1189-99.

Association of pain with falls and fractures among middle-aged Korean community-dwelling adults.

The relationship between pain and falls remains controversial. Therefore, this study explored the associations between pain and fall-related outcomes in 5,340 middle-aged (45-65 years) adults residing in the communities in Korea. Pain was defined as pain at any location, pain-related activity restriction (PAR), and persistent pain. The outcome measures included fall injuries, recurrent falls, injurious falls, and fall-related hip fractures. A multivariate logistic regression model was used to examine the relationship between pain and fall outcome. Among the study participants, 54.0% reported having experienced pain. During a follow-up period of up to 14 years, those who reported pain and PAR at baseline exhibited a positive association with the occurrence of fall injury (odds ratio [OR] 1.79, 95% confidence interval [CI] 1.27-2.53) and injurious falls (OR 1.72, 95% CI 1.20-2.48) but not with recurrent falls (OR 1.90, 95% CI 0.80-4.54). We also observed a positive association between persistent pain and the risk of fall injury (OR 1.41, 95% CI 1.13-1.91), whereas no consistent conclusions were drawn regarding the risk of recurrent falls and injurious falls. We also did not identify any correlation between pain and hip fractures resulting from falls. In conclusion, our findings of the positive correlations of pain and PAR at baseline with fall injuries and injurious falls but not recurrent falls during follow-up suggest that public health initiatives should prioritize pain screening, especially for participants reporting ankle and toe pain, and implement suitable interventions to mitigate the risk of falls and the associated adverse outcomes among middle-aged adults.

Impact of lifestyle on erectile dysfunction: literature review and educational recommendations

Introduction: Erectile dysfunction (ED) represents a significant health problem that can have a negative impact on men's quality of life, intimate relationships and self-esteem. ED is a marker of overall health, requiring a comprehensive diagnostic and therapeutic approach. This article highlights the need for an integrated approach, in which lifestyle modifications are key to the successful treatment of erectile dysfunction. Aim of the study: The aim of this article is to provide a comprehensive review of the literature on erectile dysfunction, with the intention of improving understanding of the condition and providing directions for future research and clinical practice. Materials and methods: Electronic databases, including PubMed, Scopus, Web of Science, and Google Scholar, were searched to identify studies and literature reviews on erectile dysfunction (ED). The state of knowledge: This review examines the epidemiology, pathophysiology, and risk factors associated with ED, emphasizing the importance of lifestyle in prevention and treatment. The role of diet, physical activity, weight reduction, smoking cessation, and alcohol restriction in improving erectile function is discussed. The article also presents current diagnostic and therapeutic approaches, including pharmacotherapy, alternative therapies and psychological interventions. Conclusions: Erectile dysfunction (ED) is a complex health issue that necessitates a comprehensive and interdisciplinary diagnostic and therapeutic approach. Lifestyle plays a pivotal role in the prevention and treatment of ED, and its modification should be an integral component of any treatment plan.

Association Between Restricting Symptoms and Disability After Critical Illness Among Older Adults

Objectives: Older adults who survive critical illness are at risk for increased disability, limiting their independence and quality of life. We sought to evaluate whether the occurrence of symptoms that restrict activity, that is, restricting symptoms, is associated with increased disability following an ICU hospitalization. Design: Prospective longitudinal study of community-living adults 70 years old or older who were interviewed monthly between 1998 and 2018. Setting: South Central Connecticut, United States. Patients: Two hundred fifty-one ICU admissions from 202 participants who were discharged alive from the hospital. Interventions: None. Measurements and Main Results: Occurrence of 15 restricting symptoms (operationalized as number of symptoms and presence of ≥ 2 symptoms) and disability in activities of daily living, instrumental activities of daily living, and mobility was ascertained during monthly interviews throughout the study period. We constructed multivariable Poisson regression models to evaluate the association between post-ICU restricting symptoms and subsequent disability over the 6 months following ICU hospitalization, adjusting for known risk factors for post-ICU disability including pre-ICU disability, frailty, cognitive impairment, mechanical ventilation, and ICU length of stay. The mean age of participants was 83.5 years (sd, 5.6 yr); 57% were female. Over the 6 months following ICU hospitalization, each unit increase in the number of restricting symptoms was associated with a 5% increase in the number of disabilities (adjusted rate ratio, 1.05; 95% CI, 1.04–1.06). The presence of greater than or equal to 2 restricting symptoms was associated with a 29% greater number of disabilities over the 6 months following ICU hospitalization as compared with less than 2 symptoms (adjusted rate ratio, 1.29; 95% CI, 1.22–1.36). Conclusions: In this longitudinal cohort of community-living older adults, symptoms restricting activity were independently associated with increased disability after ICU hospitalization. These findings suggest that management of restricting symptoms may enhance functional recovery among older ICU survivors.

Postoperative management following endoscopic skull base surgery.

The purpose of this opinion is to review current evidence regarding postoperative management following endoscopic skull base surgery. Postoperative management encompasses consideration of level of care, laboratory tests, analgetic and antiemetic therapy, antibiotic, antithrombotic and antiepileptic prophylaxis, pharmacological and nonpharmacological cerebrospinal fluid (CSF) pressure reduction measures, including CSF diversion, activity restrictions, nasal packing removal, nasal debridement and toilet, nasal glucocorticoid administration, positive pressure ventilation, imaging, CSF leak diagnosis, and future perspectives. Although significant effort has been put into research of postoperative measures after endoscopic skull-base surgery, there is a heterogeneity of practices and deficit of high-level studies, which would enable highly powered systematic reviews and meta-analyses.

The History and Impact of Prescribing Orthokeratology for Slowing Myopia Progression.

This paper discusses the history and impact of orthokeratology on slowing the progression of myopia. It discusses the origins and evolution of orthokeratology from polymethymethaccrylate lenses worn during the day to its current prescribing of highly permeable, innovative reverse-geometry designs worn only while sleeping. Technological advances in corneal topography, lens design, lens materials, and manufacturing have facilitated growth of orthokeratology to a precise and predictable procedure. More recently, significant interest in orthokeratology has been stimulated by its efficacy in slowing axial elongation in myopic children. Safety of children wearing contact lenses while sleeping has been an ongoing concern. The potential of serious complications exists, but long-term studies and clinical experience have shown that risks of those events can be minimized with strict compliance with lens cleaning, disinfection, and hand hygiene. Because no correction is required during waking hours, patients using orthokeratology report higher vision-related quality of life, less activity restrictions, and more comfortable eyes compared with spectacles or contact lenses worn during the day. The future growth of orthokeratology will be fueled by the prescribing of orthokeratology as a modality to slow axial elongation and an alternative modality to spectacles, traditional contact lenses, and refractive surgery to correct refractive error.

Health-Related Quality of Life and Satisfaction in Atrial Fibrillation Patients on Anticoagulant Therapy: Differences between Vitamin K Antagonists and Direct Oral Anticoagulants; Results from the Multicentre REGUEIFA Registry.

Background: Oral anticoagulation (OAC) is pivotal in the clinical management of atrial fibrillation (AF) patients. Vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs) prevent thromboembolic events, but information about the quality of life (QoL) and patient satisfaction in relation with the anticoagulant treatment is limited. Methods: REGUEIFA is a prospective, observational, and multicentre study that included patients with AF treated by cardiologists. We included patients treated with VKAs or DOACs. The EuroQol-5D (EQ-5D) questionnaire evaluated QoL, and the Anti-Clot Treatment Scale (ACTS) questionnaire investigated patient satisfaction with OAC. Results: A total of 904 patients were included (532 on VKA and 372 on DOACs). A total of 846 patients completed the EQ-5D questionnaire, with results significantly worse in patients on VKAs than on DOACs: more mobility limitations (37.6% vs. 24.2%, p < 0.001), more restriction in usual activities (24.7% vs. 18.3%, p = 0.026), more pain/discomfort (31.8% vs. 24.2%, p = 0.015), a lower visual analogue scale (VAS) score (66.4 ± 16.21 vs. 70.8 ± 15.6), and a lower EQ-D5 index (0.79 ± 0.21 vs. 0.85 ± 0.2, p < 0.001). After adjusting for baseline characteristics, VKA treatment was not an independent factor towards worse EQ-5D results. Also, 738 patients completed the ACTS questionnaire, and burden and profit scores were lower in patients on VKAs than for DOACs (52.1 ± 8.4 vs. 55.5 ± 6.8, p < 0.001 and 11.1 ± 2.4 vs. 11.8 ± 2.6, p < 0.001, respectively). The negative impact score was higher for VKAs than for DOACs (1.8 ± 1.02 vs. 1.6 ± 0.99, p < 0.001), with a general positive impact score lower for VKAs than for DOACs (3.6 ± 0.96 vs. 3.8 ± 1.02, p < 0.001). Conclusions: Patients on VKA have more comorbidity and worse EQ-5D and VAS scores than those on DOACs. VKA has a greater burden and higher negative impact on the patient's life than DOACs.

A Microcosm Analysis of Species-Specific Responses of Chironomidae on Heavy Metal Pollution in The Nyanza Gulf of Lake Victoria

The Chironomidae family, known as "non-biting midges" in their adult stage and "bloodworms" in their larval stage, consists of diverse dipteran insects inhabiting various global aquatic environments. Despite extensive global research, data on Chironomidae in the polluted Nyanza Gulf of Lake Victoria, Kenya, is scarce, and molecular identification methods have not been explored. This study aimed to quantify heavy metal concentrations in water, sediment, and insect samples and assess their impact on Chironomid species identified using mitochondrial DNA barcoding of the cytochrome oxidase subunit 1 (COI) gene. Analysis of Variance was used to determine if there were any statistically significant differences in heavy metal concentrations across different sample types or locations along the pollution gradient. Chironomids were collected from Nyanza Gulf, focusing on a pollution gradient. Results showed that concentrations of arsenic (As), lead (Pb), and cadmium (Cd) in insect, water, and sediment samples exceeded standard limits, while mercury (Hg) concentrations were within limits. Significant variations (p ≤ 0.05) in Pb levels were observed in water samples, and heavy metal concentrations in sediment samples varied significantly (p ≤ 0.05), with Pb showing the highest variation (p ≤ 0.0001). Insect samples exhibited significant differences (p ≤ 0.0001) in As and Hg contents. Genetic analysis identified two known species: Chironomus transvaalensis at the heavily polluted Kisumu station and Chironomus pseudothummi at the moderately polluted Kendu Bay and Homa Bay stations. Additionally, a unique Chironomus species was found on Ndere Island, a relatively clean site with restricted human activities. Sequence comparisons indicated proximity to global data but also highlighted the evolutionary significance and uniqueness of the identified species. This study demonstrated the potential use of genetic methods in determining Chironomid species diversity, community structure, and abundance in relation to heavy metal concentration. It suggests that heavy metal pollution may act as a selective pressure, driving the evolution of Chironomid species. The study recommends combining genetic approaches with other pollution sources for a comprehensive understanding of using this species in monitoring pollution

COVID-19 Pandemic and Violence Against Children

During the COVID-19 pandemic, it was known that number violence to child in Indonesia more increase. Study this is study References with objective for study reason happening violence against children During the COVID-19 pandemic and effort in prevention. Factor common causes of hard cake on children during the COVID-19 pandemic is a problem economy as a result of activity restrictions during pandemic, the relationship between children and parents who are not balanced, and low parental knowledge related with parenting patterns. Impact period short of perceived violence children is to affect the child 's physical, while the impact long-term related to the psyche of the victim. In overcoming, The problem of violence against children during the COVID-19 pandemic must be carried out in a social environment with various preventive measures. On In this research, the author suggests there needs to be awareness, that acts of violence against children are extraordinary crimes that can interfere with the growth and development of children.

Оценка болевого синдрома в реабилитационных мероприятиях после операции по поводу разрыва ахиллова сухожилия

INTRODUCTION. Patients who have been injured need an early start of rehabilitation measures. This is due to the fact that prolonged restriction of motor activity, lack of exercise, vascular and other changes lead to muscle atrophy, limited mobility in joints, impaired metabolic processes in the extremities, loss of functional conditions. AIM. To optimize the complex of measures for early rehabilitation after surgery for Achilles tendon rupture, taking into account the assessment of pain syndrome. MATERIAL AND METHODS. The research work was carried out at the Department of Medical Rehabilitation and Sports Medicine. To implement the tasks set, the following stages were introduced: a critical analysis of domestic and foreign sources, the development of an individual rehabilitation plan with an assessment of pain syndrome. RESULTS AND DISCUSSION. For effective rehabilitation in the postoperative period, it is important to objectively control the patient's pain sensations, gradually increasing the load on the damaged tendon. The pain monitoring and weight load dosing scale based on the visual analog scale has found wide application. Visual analog scale consists of a horizontal line on which the extreme points correspond to 0 points (no pain) and 10 points (maximum unbearable pain). The patient marks a point on this line corresponding to his current pain level. The pain syndrome was assessed on the day of surgery, and then on the 7th, 14th, 21st, 35th, 42nd and 49th days of follow-up after surgery. If by the end of the second week after surgery, the pain syndrome is 0-2 points, this indicates a favorable healing process and the possibility to begin early mobilization of the tendon. During this period, you can gradually increase the weight load on the limb, starting with partial support on the foot. If the pain syndrome persists, it is more than 2 points according to visual analog scale by the end of the second week, which may indicate the development of complications that prevent normal healing: inflammation, failure of sutures, suppuration of the surgical wound. CONCLUSION. The proposed technique using a visual analog scale is a tool for assessing pain and functional status in the preparation of a set of measures for early rehabilitation after surgery for rupture of the Achilles tendon. The assessment of pain symptoms is a determining factor in the introduction of early tendon mobilization. KEYWORDS: Achilles tendon rupture, pain syndrome, early rehabilitation

Soil microbial respiration does not respond to nitrogen deposition but increases with latitude

AbstractFacing global changes, substantial modifications in soil microbes and their functions have been widely evidenced and connected. However, the response of soil microbial respiration (MR) to increasing nitrogen (N) deposition and the role of microbial characteristics in controlling this response remain elusive. In this study, we quantified the intensity of the soil MR in terrestrial ecosystems that suffered elevated N deposition. High‐throughput quantitative sequencing and phospholipid fatty acids were employed to analyse microbial community properties and biomass, whilst microbial necromass was quantified using biomarker amino sugars. Our results revealed that soil MR kept stable under N deposition. Microorganisms maintained their respiration rates by modifying the characteristics of enzymes rather than altering microbial community properties or biomass. Notably, soil MR increased with latitude across study sites, which was attributed to the restriction of microbial activity by bacterial necromass. Supporting this observation, the recalcitrance of the soil carbon (C) pool to microbial degradation was evidenced to be the stability mechanism underlying the spatial variations in MR. Overall, we propose that MR is resistant to short‐term N deposition, whilst it exhibits a pronounced latitude dependence as shaped by the recalcitrant C pool. Our findings provide crucial insights into the microbial mechanisms of soil C dynamics under global change, contributing to the advancement of soil C models.

Improving Work Rehabilitation Program at PT. KALPRI

The work rehabilitation program is one of the important efforts made by the company to help employees who are experiencing health conditions that disrupt work productivity to return to work optimally at PT. KALPRI, there has been an increase in the number of employees undergoing work rehabilitation programs accompanied by a low success rate in returning employees to their original positions after undergoing the program. Therefore, this study aims to identify the factors that cause this condition to occur. This research uses a descriptive quantitative approach, using a questionnaire instrument for 71 respondents and conducting in-depth interviews with 5 members of the rehabilitation committee at PT. KALPRI. The collected data is then analyzed to identify the key factors influencing the increase in rehabilitated employees and the program’s low success rate. The research results show that the internal factors causing the rise in the number of employees being rehabilitated are the employees’ unhealthy habits and lifestyles, such as smoking habits, irregular exercise, and rest, which trigger the emergence of various diseases such as cardiovascular, musculoskeletal, and obesity. Externally, the COVID-19 pandemic has also contributed to the increase in the number of employees being rehabilitated due to restrictions on activities that have impacted employee health. Meanwhile, the internal factors that cause the low success rate of the rehabilitation program are the employees’ habits and lifestyles that slow down the healing process, so some employees have to undergo a “long sick” program that extends the rehabilitation period. Externally, the activity restrictions due to the COVID-19 pandemic have also contributed greatly to the low reabsorption of employees after undergoing a rehabilitation program. The findings of this study indicate the need to increase more intensive health interventions and education to change employees’ habits and lifestyles, as well as the need for stronger coordination between the rehabilitation team and management in managing work rehabilitation programs, especially during the pandemic. These efforts are expected to help improve PT. KALPRI’s work rehabilitation program’s success.

Activity restriction and risk of adverse pregnancy outcomes

BackgroundActivity restriction is a common recommendation given to patients during pregnancy for various indications, despite lack of definitive data showing improvements in pregnancy outcomes. ObjectiveTo determine if activity restriction (AR) in pregnancy is associated with decreased odds of adverse pregnancy outcomes (APOs). Study designSecondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b) prospective cohort. Nulliparous singletons were followed at 8 sites from October 2010–September 2013. Demographic and clinical data were collected at 4 timepoints, and participants were surveyed about AR recommendations at 22w0d-29w6d and delivery. We excluded participants missing data on AR and age. Participants were grouped according to history of AR, and APOs included: gestational hypertension (gHTN), preeclampsia/eclampsia, preterm birth (PTB), and small for gestational age (SGA) neonate. Associations between AR and APOs were examined using uni- and multivariable logistic regression models adjusting for a priori identified APO risk factors. ResultsOf 10,038 nuMoM2b participants, 9,312 met inclusion criteria and 1,386 (14.9%) were recommended AR; participants identifying as Black (aOR 0.81 [95% CI 0.68–0.98]) or Hispanic (aOR 0.73 [95% CI 0.61–0.87]) were less likely to be placed on AR when compared to those identifying as White. Overall, 3,197 (34.3%) experienced at least one APO (717 [51.7%] of participants with AR compared to 2,480 [31.3%] participants without AR). After adjustment for baseline differences, the AR group had increased odds of gHTN (aOR 1.61 [95% CI 1.35–1.92]), preeclampsia/eclampsia (aOR 2.52 [95% CI 2.06–3.09]) and iatrogenic and spontaneous PTB (aOR 2.98 [95% CI 2.41–3.69]), but not delivery of an SGA neonate. ConclusionAR in pregnancy was independently associated with increased odds of hypertensive disorders of pregnancy and PTB, but future prospective work is needed to determine potential causality. Further, participants identifying as Black or Hispanic were significantly less likely to be recommended AR compared to those identifying as White. While AR is not an evidence-based practice, these findings suggest bias may impact which patients receive advice to limit activity in pregnancy.El resumen está disponible en Español al final del artículo.

Expanded roles of community health workers to sustain malaria services in the Asia-Pacific: A landscaping survey.

Malaria Community Health Workers (CHWs) in the Greater Mekong Subregion (GMS) are an important component of malaria elimination efforts. As malaria declines with intensified efforts to eliminate by 2030, expanding their roles beyond malaria could help to sustain funding and provision of malaria services at the community level. Evidence of how programmes have implemented and managed CHWs performing both malaria and non-malaria roles across the Asia-Pacific region can provide insight into the viability of this strategy. A short survey was distributed to national malaria programmes and implementing organizations in the Asia-Pacific region in 2021-2022. The survey identified CHW programmes in the region, and collected information on malaria and non-malarial services provided by CHWs, characteristics of each identified programme, and the impact of COVID-19 on these programmes. 35 survey responses identified 28 programmes in 14 countries. The most frequently reported services provided by malaria CHWs were health promotion and education for malaria (13/14 countries) and other diseases (11/14); and COVID-19 related activities (10/14). Most programmes were financed wholly through donor funding (18/28 programmes), or donor plus government funding (6/28). Of 21 programmes which performed programme evaluation, only 2 evaluated their impacts on diseases beyond malaria. Declining donor funding, and COVID-19 related travel and activity restrictions were identified as implementation challenges. CHWs across the Asia Pacific provide a range of health services with malaria and are resilient under changing public health landscapes such as the COVID-19 pandemic. Further investigation into the impact of additional roles on malaria CHW performance and targeted health outcomes is needed to verify the benefits and feasibility of role expansion. As the GMS approaches elimination, and funding declines, verifying the cost effectiveness of malaria CHW programmes will be vital to persuade donors and countries to invest in malaria CHWs to sustain malaria services, and strengthen community-based health care.

DEVELOPMENT AND INITIAL TESTING OF A BRIEF, GENERIC, SELF-REPORTED DISABILITY QUESTIONNAIRE: THE UNIVERSAL DISABILITY INDEX

BackgroundDisability is an important multifaceted construct. The aim of this study was to develop and evaluate a brief, generic self-reported disability questionnaire: the Universal Disability Index (UDI).MethodsConvenience sampling was used to collect general population data via an online survey. Data were randomly divided into training and validation subsets. The dimensionality and structure of eight UDI questionnaire items were evaluated using exploratory factor analysis (EFA, training subset) followed by confirmatory factor analysis (CFA, validation subset). To assess concurrent validity, the UDI summed score from the full dataset was compared to the Groningen Activity Restriction Scale (GARS) and the Graded Chronic Pain Scale (GCPS) disability scores. Internal consistency was also assessed.Results403 participants enrolled; 364 completed at least one UDI item. Three single-factor versions of the UDI were assessed (8-item, 7-item, and 6-item). All versions performed well during EFA and CFA (182 cases assigned to each), but none met the RMSEA (Root Mean Square Error of Approximation) criterion (≤ 0.08). All versions of the UDI had high internal consistency (Cronbach's α &gt; 0.90) and were strongly correlated (Pearson's r &gt; 0.7) with both GARS and GCPS disability scores, indicating concurrent validity.ConclusionsA brief, generic self-reported disability questionnaire was found to be valid and to possess good psychometric properties. The UDI has a single factor structure and either a 6-item, 7-item or 8-item version can be used to measure disability. For brevity and parsimony, the 6-item UDI is recommended, but further testing of all versions is warranted.Conflicts of interestNo conflicts of interestSources of fundingNo funding obtained

MEASURING THE PREVALENCE, SEVERITY, AND SOURCES OF DISABILITY: A NEW APPROACH

BackgroundDisability is an important multifaceted construct. Identifying sources of disability could help optimise patient care. The aim of this study was to test an approach that not only estimates severity of disability, but also identifies the source(s) of this disability.MethodsAn online survey was used to collect data from a convenience sample, recruited via email and social media invitations. Two generic measures of disability, the 8-item Universal Disability Index (UDI8) and Groningen Activity Restriction Scale (GARS) were used to estimate the prevalence and severity of disability in this sample. Non-zero UDI8 item responses generated conditional sub-questions, in which participants could attribute their activity limitations to one or more sources (pain, fatigue, worry, mood, and other). This allowed for a decomposition of UDI8 scores into source components.Results403 participants enrolled; 334 completed all UDI8 and GARS items. Of these, 85.3% (285/334) reported at least one restricted activity via the UDI8, while 43.4% (145/334) reported some reduced independence via the GARS. Disability severity increased with age until approximately 40 years, after which it decreased gradually. Pain component scores were high in all individuals with higher and lower disability severity, whereas fatigue component scores were highest in individuals reporting higher disability severity. Worry, mood, and other component scores were not high at any level of disability severity.ConclusionsThis approach should be used to identify the prevalence, severity and sources of disability in the general population and in specific patient groups.Conflicts of interestNo conflicts of interestSources of fundingNo funding obtained

Morbimortality profile by COVID-19 in telework and on-site work in an oil and gas company in Brazil.

As a reflection of the health emergency caused by COVID-19, many countries adopted guidelines, which included activity restrictions. As a result, some companies maintained their activities with on-site work and telework. Analyzing the morbidity and mortality profile due to COVID-19 of workers in telework and on-site work in an oil and gas company. Cross-sectional, quantitative, and analytical study that included 8,394 workers diagnosed with COVID-19 at an oil and gas company in Brazil, from June 2020 to June 2021. The company's Surveillance Program database was used as an information source. The total prevalence of cases was 21.7%. For teleworking and face-to-face workers, they were 20.7% and 23.3%, respectively. There was a predominance of women (19.7%), white ethnicity/colour (64.7%), higher level position (52.6%), age group over 40 years (36.7%), married (53, 8%), working at the company for a period that ranges from 7 to 10 years (17%), administrative activity (68.5%), and a higher number of symptomatic workers and deaths in telework compared to on-site work. The results suggest that testing is important to refrain the virus spread in the company's work environments, as it allowed asymptomatic workers to be diagnosed with COVID-19. The study suggested that on-site work was not a transmission facilitator in the occupational environment, which points out the importance of preventive measures in the workplace and the adoption of remote work for the largest possible number of workers to improve the safety of employees, workers who remained in the on-site work modality.

Nexus between Economic Policy Uncertainty and Bank Liquidity Creation

Purpose: This paper analyzes the effects of economic policy uncertainty (EPU), bank regulations, and credit risk on the asset and liability sides of liquidity creation in developed and developing countries. Methods: The sample comprises 100 companies in developed and developing countries from 2015 to 2021. We used a dynamic Generalized Method of Moments (GMM) estimator to test the hypothesis. We also performed the Sargan test of over-identification or J-statistics to check the validity of instruments in the GMM model. Additionally, we conducted a robustness test on our analysis based on average assets and average capital. Results: We find that Economic Policy Uncertainty (EPU) significantly negatively impacts asset-side liquidity creation in developed and developing countries. However, EPU significantly positively impacts liability-side liquidity creation only in developed countries. Interestingly, higher credit risk can effectively counteract the adverse effects of EPU on asset-side liquidity creation and encourage a positive impact on liability-side liquidity creation in developed and developing countries. Moreover, stricter bank regulations, including activity restriction and capital stringency, can weaken the negative effects of EPU on asset-side liquidity creation in developed and developing countries. However, we do not find any significant effect of higher bank regulations on the relationship between liability-side liquidity creation and EPU. Implications: Since financial institutions can make riskier decisions to keep their businesses going in an uncertain economy, regulators need to act in advance to restore confidence in credit growth and financial resilience. The government should assess the short-term and long-term consequences of any policy implications. Originality: While most studies concentrate on total liquidity creation from a cross-country perspective, our study provides new evidence by breaking down liquidity creation into asset-side and liability-side liquidity creation and examining the research separately in developed and developing countries.

Climatic temperature and precipitation jointly influence body size in species of western rattlesnakes.

Both the metabolic theory of ecology and dynamic energy budget theory predict that climate influences body size through its effects on first-order determinants of energetics: reactive temperatures, carbon resources and oxygen availability. Although oxygen is seldom limiting in terrestrial systems, temperature and resources vary spatially. We used redundancy analyses and variation partitioning to evaluate the influence of climatic temperature, precipitation and their seasonalities on multivariate body size across the distributions of four species of the western rattlesnake group in North America (Crotalus pyrrhus, C. scutulatus, C. oreganus and C. viridis). Most species showed a pattern of increased body size in cooler, mesic climates and decreased body size in warmer, xeric climates. Exceptions to the pattern provided additional context through climatic idiosyncrasies in the distributions of each species. For example, the general pattern of a negative influence of temperature on body size was not apparent for C. oreganus, which ranges across the mildest climates overall among the four species. In contrast to previous studies, we found that seasonality had negligible effects on body size. We suggest that precipitation gradients correlate positively with resource availability in driving intraspecific body size and that temperature compounds this gradient by increasing baseline metabolic demands and restricting activity in particularly warm or otherwise extreme climates.